Real-world Patient characteristics, Treatment Patterns and Costs in Relapsing Multiple Sclerosis Patients Treated With Glatiramer acetate, Dimethyl Fumarate Or Teriflunomide in Germany

Abstract

Aim: To evaluate adherence, healthcare resource utilization (HRU) and costs for glatiramer acetate (GA; injectable), dimethyl fumarate (oral) and teriflunomide (oral) in relapsing multiple sclerosis. Patients & methods: Retrospective analyses of a claims database. Results: Teriflunomide patients were older with more co-morbidities and fewer relapses versus GA and dimethyl fumarate. GA patients were mostly disease-modifying therapies (DMTs)-treatment naive. Treatment adherence was 61–70%. All DMTs reduced HRU versus pre-index. Costs were comparable across cohorts. High adherence reduced hospitalizations and several costs versus low adherers. Conclusion: Adherence rates were high and comparable with all DMTs. Similar (and high) reductions in HRU and costs occurred with all DMTs. High adherence improved economic outcomes versus low adherence. Thus, investing in adherence improvement is beneficial to improve outcomes in relapsing multiple sclerosis.

Plain language summary

Drugs used for relapsing multiple sclerosis (RMS) include, among others, glatiramer acetate (injection), dimethyl fumarate (tablet) and teriflunomide (tablet). We compared treatment adherence (based on drug claims), healthcare use and costs for these drugs. Treatment adherence and healthcare use was similar for these three drugs. The need to be in hospital was lower with these drugs compared with not using them. No differences in treatment costs were seen between these drugs. Adherence reduced the need for hospital stays and lowered some costs compared with patients who were classified as adherent. RMS patients should be encouraged to take their RMS medication as prescribed. Improving treatment adherence will have a positive effect on RMS, and a good impact on healthcare use and costs.

Keywords:

• costs
• dimethyl fumarate
• glatiramer acetate
• healthcare resource utilization
• multiple sclerosis
• teriflunomide

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at:www.tandfonline.com/doi/full/10.2217/nmt-2021-0031

Author contributions

T Ziemssen contributed to the conceptualization, methodology, writing (review and edit) and supervision of this study. A Kurzeja contributed conceptualization, methodology, writing (review and edit – protocol, study report, manuscript), supervision, project administration, funding acquisition. B Muresan contributed to the writing (original; review and edit) and supervision of this manuscript. JS Haas contributed to the conceptualization, methodology, validation, writing (original; review and edit), visualization, supervision and project administration of this study. J Alexander contributed to the conceptualization, methodology, writing (review and edit) and supervision of this study. MT Driessen contributed to the conceptualization, methodology, writing (original; review and edit) and supervision of this study.

Acknowledgments

The data analysis was performed in cooperation with Wolfgang Greiner and the Institut für angewandte Gesundheitsforschung Berlin (InGef).

Financial & competing interests disclosure

This study was sponsored by Teva Pharmaceuticals. T Ziemssen declares advisory boards fees from Bayer, Biogen, Celgene, Merck, Novartis, Roche, Sanofi-Genzyme and Teva; speaker fees from Almirall, Bayer, Biogen, Celgene, Novartis, Roche, Sanofi-Genzyme and Teva; research support from Biogen, Novartis, Sanofi-Genzyme and Teva. JS Haas is an employee of Xcenda GmbH; Xcenda received funding and consulting fees for the conduct of this study from Teva Pharmaceuticals. A Kurzeja, B Muresan, J Alexander and MT Driessen are employees of Teva Pharmaceuticals. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Medical writing support for this manuscript was provided by Jackie Phillipson, Ashfield Health, part of UDG Healthcare, and was funded by Teva Pharmaceuticals.